Effects of surgical volumes on the survival of endometrial carcinoma
Section snippets
1. Introduction
Endometrial carcinoma is the most common gynecological malignancy with an incidence of 82,500 newly diagnosed women and 21,700 disease specific deaths per year in Europe [1]. Due to a relatively early detection and good prognosis of early stage disease, the mortality rate is relatively low. Bokhman et al. classified endometrial cancer into two groups: Type 1 endometrioid endometrial carcinoma (EEC), the most common, is considered to be hormone-dependent and has a relatively good prognosis,
2.1. Design and patients
In this population-based retrospective study, all women diagnosed with endometrial carcinoma between January 2005 and December 2010 in The Netherlands were selected. Only women who were surgically treated were included. Of all registered corpus uteri malignancies, we included endometrioid-type, clear cell-type, serous-type and mixed-type endometrial carcinomas (appendix), since these types contribute to over 98% of endometrial carcinomas. All other types of endometrial carcinomas were excluded
3.1. Patients and hospitals
Between January 1st 2005 and December 31st 2010, 10,554 patients were diagnosed with endometrial carcinomas in the Netherlands. Of these women, 689 received non-surgical treatment for endometrial carcinoma, such as radiotherapy, chemotherapy, hormone therapy or a combination of these treatment modalities. Of 732 women, data were missing regarding hospital of treatment; these women were therefore excluded from analyses (Fig. 1). Of the remaining 9133 women, 2596 (24.4%) women were treated in 42
4. Discussion
In this large population based study, no association was observed between surgical volumes and the relative survival of women that were surgically treated for endometrial carcinoma.
Although we expected to find an improved relative survival among hospitals with higher surgical volumes, especially for the high-risk endometrial carcinomas and the complex surgical treatment of endometrial carcinomas, no such difference was found.
To fully understand the impact of our findings, it is important to
Conflicts of interest
All authors declare not to have any financial, personal or other conflicts of interests.
Acknowledgements
We acknowledge the Dutch Comprehensive Cancer Organization and the Netherlands Cancer Registry for the use of their data collection and interpretation.
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2019, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :The quality of EC management has been evaluated only in a few studies [2,3]. Wright et al. suggested that surgeons and hospital activity volume have both (surgeon activity, and hospital oncological activity) a little effect on perioperative morbidity and mortality [4,5]. Moreover, it has been shown that EC with higher risk of extra-uterine disease, who may require lymphadenectomy, should be referred to a gynecological oncologist.
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